In 2008 Alice Dogruyol representing The Spa PR Company wrote to me requesting I plug a new genital cosmetic procedure – the g-shot. It involved injecting collagen into the vaginal wall. And was being spearheaded in the UK by a Professor Phanuel Dartey of Harley Street.

I immediately noticed there seemed to be no robust peer reviewed clinical evidence for the safety and effectiveness of the g-shot procedure. I felt the press release I was sent was so poor and the ‘treatment’ described seemed so bizarre that it was best ignored. I assumed no media outlet would pick up on it.

I was wrong.

Several newspapers including the Sun, Mirror, Telegraph and Mail clearly had been sent the same press release as me. The only difference was they joyfully publicized the g-shot and promoted Prof Dartey’s Harley Street practice. And in the case of the Sun and the Mirror the pieces were written by their Health and Science correspondents. Who really should have known better. Since then many women’s magazines and websites have also described the procedure as a sex life enhancer, promoting both the g-shot and Laser Vaginal Surgery (which Dartey also offered).

I was so concerned I wrote a blog post about the problems I foresaw with the g-shot procedure and subsequent media coverage. I also outlined core questions journalists and the public ought to be asking about it.

A journalist colleague then tried to pitch a story critiquing the g-shot , but they were unsuccessful. Over the past three years I sent my blog post questioning the g-shot to any media outlet I spotted giving it publicity. In most cases I heard nothing back. Occasionally a journalist would politely thank me and tell me they’d consider my opinions if they wrote similar pieces in the future.

In other words they ignored my concerns and questions. Probably because they weren’t as exciting as the sexy ‘science’ of collagen injections, and probably because anyone critiquing their breathy discussions of amazing orgasms through genital enhancement could be dismissed as an anti capitalist/feminist/academic killjoy.

I did not systematically continue to campaign against the g-shot because I reasoned even if the media were occasionally (albeit enthusiastically) covering it, I doubted many women would opt for either the g-shot or Laser Vaginal Surgery.

I was wrong here as well.

Last week Phanuel Dartey was struck off by the General Medical Council (GMC).

This followed complaints from five women. The British Medical Journal (16 November) reports Dartey ‘botched laser operations on four women and left another seriously ill after a termination’ . It goes on to report from the GMC hearing:
“Patient A was said to have suffered visible scarring and asymmetry of her genitals, although she had been told that the incisions would be nearly invisible. Part of her vagina had been “effectively amputated,” and she required revision surgery
Patients B and C were given laser surgery for urinary incontinence, which the GMC’s experts say would have been of “limited value”.
Patient E was in major pain after a labioplasty to reduce the size of her labia minora, which Dr Dartey is said to have “significantly over-reduced.” When she complained of the pain, the GMC alleges that he suggested an injection of absolute alcohol into the area of the labial scar to kill the nerve endings, an intervention that was “inappropriate.”
Patient D travelled from Ireland to the Marie Stopes centre for a termination at 18 weeks’ gestation. Dr Dartey is alleged to have perforated her uterus during the procedure but failed to recognise this.
The GMC alleges that he failed to check that all the products of conception had gone and failed to notice that the fetal thorax had not been removed. When D returned home, she became “extremely ill,” … “She was on the critical list and was in hospital for two months.”
Dr Dartey, who was suspended from practice pending the hearing, is also charged with having no valid medical indemnity insurance when he carried out the termination in February 2006”.

A further report of the hearing, again from the BMJ (6 December), explains why Dartey was struck off:
“Robin Knill-Jones, who chaired the GMC’s fitness to practise panel, said, “In the panel’s judgment there is a continuing risk to patients from the way Dr Dartey conducts his practice. His dishonest actions in relation to professional indemnity were a serious abuse of the trust that his patients and those with whom he worked were entitled to place in him.
“The panel considers that the extent and seriousness of Dr Dartey’s clinical misconduct, the gravity of his dishonesty, and his subsequent lack of insight evidence a harmful attitudinal problem.”
When Dr Dartey carried out the termination in 2006 on a woman who had travelled from Ireland, he perforated her uterus and failed to remove the fetal thorax. When she returned home she became extremely ill and was in hospital for two months, the panel heard.
Dr Dartey’s membership of the Medical Protection Society had lapsed in 2002, and he had no indemnity cover when he performed the abortion. The panel found that a membership certificate he sent to Marie Stopes International purporting to cover 2005-6 was a forgery.
Dr Knill-Jones said, “Each of the five patients with which this inquiry has been concerned has suffered from the events in question. In his written communications to the GMC Dr Dartey has shown little remorse or acknowledgment of, or insight into, his failures.
“He has rather adopted a derogatory attitude towards his patients, accusing one of racism, another of blackmail, a third of causing her own problems by failing to follow his advice, and another of reporting him to the GMC because she wanted free corrective surgery for an unrelated problem. The panel has found no substance in any of these complaints and regards Dr Dartey’s lack of insight as a matter of serious concern.””
The lack of insight comment seems particularly relevant given that during the time the GMC were investigating his case, and while it was being covered in the media, someone claiming to be Professor Dartey appeared to comment at Ghanaweb where he belittled those complaining against him. This comment has not been verified as from Prof Dartey but it seems uncannily similar to the report from the GMC hearing.

This is truly shocking case that raises questions about the conduct and supervision of medics in private practitice. Marie Stopes also undoubtedly need to review procedures for the selection and supervision of staff working at their clinics.

The media also has a role to play here, but this was not (as far as I know) picked up on at the GMC investigation.

The PR company who promoted Dartey and the journalists who covered his g-shot and Laser Vaginal Surgery interventions in uncritical and often glowing terms are, in my opinion, culpable.

We know from research on women seeking cosmetic genital surgery one of the main things that persuades them they need cosmetic procedures is advertising from clinics/consultants. And how better to advertise than via an enthusiastic media endorsement? Even though it is well documented there’s no evidence of effectiveness of cosmetic genital surgery but plenty of evidence of active efforts by medics to promote such practices.

Perhaps unsurprisingly the papers that fawned over the g-shot have been remarkably silent about the GMC hearing. And none have admitted they gave publicity to an untested and dangerous cosmetic intervention.

The only paper who reported in favour of Dartey and also on his striking off was The Daily Mail. They managed an incredible about face with their initial piece ‘I’ve had the G Shot and YES, YES, YES my sex life has never been better!’ promoting the g shot procedure. While Dartey’s GMC investigation was ongoing they were still publishing testimonies in his favour. Finally describing his fall from grace in less than glowing terms. The latter piece, of course, made no reference to the former. (Thanks to @MrNorthice for helping with these links).

This media distancing could be coincidence, or it may be more deliberate. In the Mail’s case it can be seen as deliberate in the way Dartey is talked about. When his g-shot procedures are being lauded he’s a Professor from Harley Street. When his striking off is detailed his qualifications from the Soviet Union and Ghanaian heritage are at the fore. As @PeteDeveson astutely commented on twitter: “on the way up it’s “Hollywood” and “Harley Street”. On the way down it’s “Ghana” and “Soviet””. This xenophobic coverage neatly airbrushes any involvement of the newspaper in promoting Dartey’s practice – and subsequent harm done to his patients.

When I first read the press release about the g-shot it raised not so much a red flag as a string of red bunting. I tried to challenge it where possible with journalists but felt powerless to really get anyone to listen.

I still feel powerless about this situation and the countless others like it. Journalists cover stories on sex and health topics that advocate untested treatments, products and procedures. Therapists and practitioners are showcased with no check on their skills, qualifications or professional ethics. Cosmetic genital surgery is increasingly presented as ‘the norm’ and if any criticism is allowed it is always a small voice of dissent in a wider promotion of surgical intervention. While this case concerns surgery performed on women, men’s media is just as problematic when it comes to promoting dodgy sex pills, potions and procedures.

Of course claims that science, medicine and surgery can transform your sex life, give you amazing orgasms, make you more desirable or a better lover are beguiling to both editors and the public.

Sadly these claims are rarely put to the test.

Which allows dangerous practices like those offered by Professor Dartey to go unchecked.

Editors and journalists lack basic skills to evaluate press releases or stories they are sent about sex-related products and procedures. Either because they are busy, seduced by science speak, or unable to critically evaluate medical claims. More importantly editors and journalists do not make enough use of willing qualified individuals and organisations who could help them assess whether claims they’re about to write about are accurate or not (for example using guides like this one created by Dr Jennifer Gunter). Where practitioners try and tell them they could be advocating something that is ineffective at best, life threatening at worst, the media (for the most part) ignores them.

We should be rightly angry with the media and with practitioners who promote untested and unnecessary cosmetic genital surgery.

This will be of little comfort to the five women involved in this case, who will be scarred psychologically and physically for the rest of their lives.

Professor Dartey should be ashamed of his actions, but GMC reports imply this is unlikely.

The journalists who didn’t bother checking a simple press release and promoted his products and services should also be ashamed of their actions. Again, I think this is unlikely.

The Spa PR Company who originally promoted the g-shot and Dartey’s clinic should also take responsibility for their role in this tragedy. I have written to them offering a right to reply which I will post here if they wish me to.

Other media outlets could now write about this case critically, and make a commitment to reporting on sex/science stories ethically and carefully. They could campaign against cosmetic genital surgery or refuse to showcase it in their features or advertising. Here too I expect this is unlikely.

It is easy to forget in stories like this how real lives can be destroyed. My sympathies are with the women affected by Dartey’s professional misconduct. While I find it easy to compile a case against media and medical incompetence, I find I lack the words to adequately express how badly I feel for them.

The papers are full of a new survey of female twins that’s about to be published in the Journal of Sexual Medicine. As part of a ‘debate issue’ on the g spot, this research by a team of UK scientists claims the g spot does not exist. Here’s a taster of some of the press coverage.

G spot ‘is just in the mind’ – The Express
Sexy g-spot a myth – New York Post
What an anti-climax – g spot is a myth – The Times

This research is brought to you by the team who also gave us studies (presumably carried out on the same cohort of twins) suggesting an infidelity gene; claiming (emotionally) intelligent women have more/better sex (covered here and here, that orgasm (and orgasmic problems) is genetically determined – plus a criticism that women shouldn’t orgasm too easily. As you’ll see within these links there are numerous problems around the conceptualisation and measurement of sexual response and orgasm within these research reports.

Backplot to the g spot
The G spot is not without controversy. Originally identified (in research) by Ernst Grafenberg the 1950s. It was remamed the g spot in his honour in the 1980s by Beverly Whipple and colleagues who revived discussions of the g spot in science and popular culture. Debates have raged since then over the importance and existence of the g spot, summarised neatly in this recent account from sex educator Betty Dodson.

The problem with much existing research on the g spot is it’s hampered by small sample sizes (for physiological research), self report in surveys, and anecdotal evidence for/against the existence of a g spot in qualitative research and popular culture. Participants are often white, middle class volunteers, and women who are bi or lesbian usually excluded from g spot studies. As have those who are not in a relationship or don’t engage in penetrative sex. Moreover inconsistent wording on interviews and questionnaires have often confused participants so it’s unclear what has been measured. Advances in research – particularly with ultrasound and thermal imaging – do offer more opportunities to study the g spot, although the political question remains about why are we so desperate to find the area and ‘prove’ its existence (or absence)?

Due in part to the 1980s revival of g spot research and also our changing commercialised and sexualised culture, the self help market was quick to pick up on the idea of a g spot. So you could go hear a sexpert tell you where yours was and how to find it, or read a book they’d written all about g spots. Or you could buy products with widgets and knobs and bendy bits to give your g spot attention. Or you could read one of the endless features in womens (and latterly) men’s glossy magazines praising the spot and telling you how to find it. Porn also shifted to include a hat tip to the g spot, although it wasn’t so easy to show. However, female ejaculation (the squirty friend of the g spot) was easy to demonstrate. Hence the popularity of this within porn currently. And most recently the cosmetic surgery industry has got in on the act offering g-shot parties where you can get a collagen injection into your vaginal wall to enhance the g spot (and make it easier for a partner to find).

The media have played no small role within this story, in particular women’s magazines keen to talk about sex but without being too raunchy. It’s no coincidence the g spot has had so much media coverage. As any journalist will tell you it’s much easier to get a g spot past your editor than mention the clitoris. Something that editors dislike and advertisers run scared of. It’s much easier to mention the g spot or show a picture of a g spot stimulating sex toy than it is to mention other genital names or frankly discuss what you actually need to do to stimulate a partner.

For some, the ability to discuss the g spot and have products available to explore it was a step forward within women’s sexual pleasure. Critics raised concerns over the focus on the g spot meant other areas of pleasure were neglected. The quest to find the spot (and the much promised g spot orgasm) created anxieties and insecurities on the part of couples. Disputes over whether women had g spots or could ejaculate meant women felt anxious. Either because they did feel they had a g spot orgasm (but science argued this was impossible), or because they didn’t have such an orgasm (but science told them they should).

In the past couple of years science has gone bananas for the g spot. In 2008 we were told the g spot definitely does exist, which the press went crazy for.

The current study
Is called ‘Genetic and environmental influences on self reporteg g spots in women: A twin study’ and will be published in the Journal of Sexual Medicine shortly (early view here). It focused on a self reported postal questionnaire sent to 4625 women. 1875 responded to specific questions about sex. Of these the researchers excluded 71 women. Those ‘who reported they were homo or bisexual were excluded from the study because of the common use of digital stimulation among theses women, which may bias the results. Also excluded were women who had never engaged in vaginal intercourse’. Respondents were aged 22-83 with a mean age of 55.

Women were asked a series of questions about their sexual practices and frequency of sexual activity, including the questions ‘overall how frequently do you experience orgasm during intercourse’ and ‘overall how frequently do you experience orgasm through masturbation’. The wording of these questions is problematic and is discussed further in the links to previous studies by this team near the start of this blog. It appears from reading the paper that the participants in this study are also those reported in the previous studies on emotional intelligence and orgasmic heritability.

To identify the presence of a g spot participants were asked “Do you believe you have a so called G spot, a small areas the size of a 20p coin on the front wall of your vagina that is sensitive to deep pressure?”. This reads like a leading question with the inclusion of ‘so called’ and I’m not sure how useful/clear all participants would have found it.

Analysis revealed that women reporting orgasms through intercourse did not necessarily report the presence of a g spot, and those who reported having a g spot noted they were likely to orgasm through other forms of stimulation such as kissing or breast stimulation.

The researchers conclude “the g spot is rather a perception created by non physiological factors that can cause a heightened sexual sensation”.

Although the paper is interesting, and the researchers are at pains to stress they want to reduce women’s anxieties about pressure to find an elusive g spot, it really doesn’t fully explain the presence or absence of a g spot. Aside from being limited by self report and problematic wording of questions, the study really seems to capture the diverse ways women enjoy pleasure rather than the requirement of a g spot to have orgasms. It’s also concerning within the introduction of the paper the researchers repeat the message they’ve written in related studies – “knowledge of the anatomy, biology, physiology, and pathophisiology of female sexual function is limited. Female orgasm, in particular, is a complex phenomenon that is far from being understood”. This indicates a worrying lack of awareness of the wider evidence base on female sexual functioning that is not limited in scope, but does take issue with the stereotype of women’s orgasm being both complex and mysterious.

Previous studies claiming the g spot absolutely existed (linked to above) were limited by small scale samples that weren’t really large enough to draw conclusions from. Although the current study draws on a larger participant group it’s based on self report and isn’t really any more reliable in showing the g spot doesn’t exist. Critics may question why the research team have produced so many papers based on the same cohort? A cynic might call allege it’s a case of ‘salami slicing’.

In short recent studies claiming the presence or absence of the g spot are all limited and none of them appear robust enough to accept a claim either way. Although interestingly all have been funded in part (or wholly) by grants from Pfizer, so one might wish to question what that company’s interest is in the g spot.

The media response to the latest (no) g spot research
As you may expect the media’s response to the current study has been (as with all previous g spot studies) uncritical, unquestioning, and not based on reading the original paper. There’s little or no reference to other studies by this particular team, nor compared with existing research claiming g spot existed. Indeed it’s as though the media’s had a complete memory wipe and haven’t noticed that two years ago they were emphatically telling us that the g spot existed. Still, this study is harder to report for journalists. When they were working on the g spot does exist study it allowed for loads of features plugging sex toys, quoting ‘sexperts’, and giving loads of top tips about the g spot and how to find/enjoy it. Not possible if you’re now reporting the g spot doesn’t exist.

So the take home message is?
It’s pretty simple. Women are diverse. Some of us really enjoy vaginal stimulation by finger, penis, sex toy (or other item). Some women prefer clitoral, anal, breast or other stimulation.

Research that tells us we should focus exclusively on one spot or ignore it completely does little to reassure us or enhance our sex lives.

During the many conversations I’ve had with journalists today on this topic, one asked me ‘should we ignore the g spot?’ which is a good question. The current study suggests we should. The trouble is the g spot is deeply embedded in popular culture and the sex product industry and it’s unlikely to just disappear because one study says they don’t think it exists. Perhaps a better way forward is to think critically about the g spot. Be aware there’s plenty of folk who make money out of your worries of whether you do or don’t have one. Go exploring, but don’t feel under pressure.

You can expect this story to run over the coming weeks – and be spun into some fairly tedious and polarised debates – during which women’s voices and experiences will most likely be ignored.

The question for science is why are we still having this debate? Why can’t we accept genital diversity and explore through rigorous and novel methods what that might mean for women – rather than these tired old does the g spot exist? Yes it does! No it doesn’t! debates.

I’ll leave you with the excellent Daily Mash, who, as ever, provide a great spin on this story – Men who care about the g spot are a myth.

Update 06.01.10 – Tom Geoghegan over at BBC News Magazine’s written a great spin off piece Err on a g spot about the G spot debate looking at the history of the topic, talking to key advisors/researchers, and including practical advice for women and their partners.

Update 12.01.10 – Katy Kelleher’s produced an excellent overview of the research and media coverage in The Mystery of the G Spot: untangling the headlines.

Edit: A reader emailed and asked me if I based the title on this blog on Paula Cole’s song Where have all the cowboy’s gone? The answer is no. I based it on Peter, Paul and Mary’s Where have all the flowers gone? (Hippie parents). Either way you can easily insert ‘where have all the g spots gone’ to each song and sing along. Meanwhile, Dr Aust suggests The Kinks song Where have all the good times gone? works even better when the term ‘g spot’ is inserted into the lyrics.

What made me start blogging?
Five years ago I sat down on a dark November evening and wrote my very first blog entry. It was a bit ranty. I’d been misquoted by a journalist and was anxious it would get me into hot water (again).

I didn’t have a game plan when I started blogging. My partner (who’s way more tech savvy than I am) thought it might be a good way of sharing ideas I was struggling to convey via the mainstream media (I was writing several advice columns in magazines at the time, as well as hosting a regular radio phone in for BBC Five Live).

I approached the blog as a form of therapy. I wanted to work with the media but was getting a lot of stick for it professionally (I’m an academic as well as a sex educator). Having a place to blog would allow me to correct any errors in reporting and disclose bad journalism. I even hoped it it might even let me bring evidence into sex/relationships reporting – and show it was possible to do so without things becoming worthy or dull.

One thing I felt sure of early on was this blog was something I enjoyed writing, but I wanted to be useful, and most importantly to deliver things about sex, relationships, science and journalism that readers wanted to know about. Which is why the blog has always been shaped by things you’ve asked for.

Readers make this blog (or “why don’t you have comments?”)
Last summer I asked regular readers to give me feedback on this blog and got some very helpful responses. It’s taken me a while to implement some of these, but I have now upgraded the blog to include the things you asked for – photos and images to liven things up, a better blogroll, summaries at the start of most entries so you can decide if you wish to read on. And categories. Something I didn’ think about five years ago and really wish I had. I’m now in the process of going back through all the 800+ posts and adding categories to them, which I hope will make this blog a lot more useful to you.

The one thing this blog doesn’t have is comments. I did start off having them, but encountered several problems. As I was offering advice within columns and websites elsewhere I hadn’t planned to also answer problems on this blog. However, not all readers understood this so I frequently found requests for advice on anything from infidelity to penis size included in discussions about blogs relating to research design or journalism ethics. This sometimes led to some readers mocking those asking for advice, which of course is completely unacceptable for me as an educator.

Moreover, I’ve always blogged openly – never behind a pseudonym. I work within the community on sex/relationships projects and educational activities (in the UK and internationally). This meant I was very accessible, and felt vulnerable when those whose comments were deleted or not posted, made very personal threats.

I found moderating the comments was time consuming and took me away from other educational activities which I felt were more worthwhile. So I decided to remove the comments option. When I’ve asked readers if they want them back the general response is ‘no’. That’s mostly from people who feel the blog’s a safe space to get information which they can use as they wish elsewhere.

Of course I strongly welcome respectful email feedback and am always happy to add information or correct errors within the blog. You’re always welcome to start discussions on other forums or your own blog about issues raised here. For now I’ve no plans to reinstate comments, but since I’m occasionally asked why I don’t have them I thought this was a good a time as any to clarify the issue.

Achievements so far
Having read back to 2004 I’m pretty pleased with this little blog. It’s nice to see it’s grown into a resource that people trust and enjoy reading.

The things I’m most proud to have written are activist blogs that highlight medicalisation, exploitation and abuse. These include the debates around female sexual dysfunction, questioning high street stores stocking ‘herbal’ erectile dysfunction drugs (not approved by the FDA), exposing the Advanced Medical Institute’s aggressive sales technique for men affected by premature ejaculation, or highlighting misleading media coverage of the availability of Viagra on the high street.

I initially planned to use the blog to set right bad sex coverage in the media (or occasions where I’d been misquoted). This has been a theme within the blog although I think it’s become more focused over time (although not necessarily less ranty than my very first post). I can’t say whether it’s made much difference to journalists, and I hope it’s not put people off working with the media. I’ve found it helpful to describe poor practice – not least because the general trend for ‘experts’ working with the media is to act grateful for any exposure, not publicly discuss poor experiences or document bad practice. Gems for me include an expose of GMTV sending a cab to my home at 6am on the off chance I might wake up and come to their studio. Or how a TV show wanted to discuss female sexual confidence without mentioning genitals or masturbation. Or some rather nasty experiences with snotty TV producers just after I’d had a baby. Not to mention the hilarious case of the science journalist who really took a dislike to me (and colleagues). Oh, and let’s not forget the journalist who wanted me to recommend them an ‘unethical psychologist’ .

Of course, the past five years have not been spent simply slagging off journalists. No. Sometimes I’ve also turned my gaze to bad science too. Where it’s been depressing to report on a carnival of studies which seem to set us back sexually. Studies complaining women orgasm too easily, or there’s a ‘clitorocentric conspiracy’ against the vagina, how sex with a partner is 400% better than any other kind of sex you might have, and you can tell whether a woman has vaginal orgasms by her walk.

Let’s not forget my other bugbears. The fake formula and shonky surveys and my goodness this blog’s a treasure chest for those. And if I’m not being irritated by that, then there’s always the problem of psychologists talking about celebrities, or the general ethical issues raised by Big Brother for me to moan about.

Of course, it’s not all been bad news. Anyone would think this blog is only about gripes and grumbles. I’ve always wanted to showcase a variety of sexual experiences within this blog and not just think about sex just for a Western audience. I’ll continue to discuss issues relating to sex and seniors; teenagers; disability; transsexuality; lesbian, gay and bi issues; open relationships; BDSM; sexual health; contraception; prostitution; pornography; reproductive health; pleasure; desire; asexuality; dating; psychosexual problems; showcasing great sex pioneers; talking about safer sex; and as many other topics as I can find for you to read about.

Where to next?
Unlike five years ago, I’m now thinking strategically about this blog – who it’s for, what it does, and seeking to find ways to assess any impact it may have. I’ve noticed over the years it sometimes deviates into areas that interest me, but may not appeal to all readers. So my aim is to ensure the focus of the blog remains around the core things you’re most interested in when you visit – sex, science, and media.

I’m currently involved in overhauling the site so in the new year I hope to have far more open access materials available for you – relationships and sex guides, information about sexual and reproductive health, more advice and links to sources of help, along with practical information for journalists, healthcare professionals, parents, teens and teachers.

I’ve been asked by many readers for more information about how to become an agony aunt/media sex educator, so I’ll be blogging about this – as well as how to write a sex blog – in the not too distant future.

I’ll also be making use of twitter soon, as sometimes I blog about issues people need to hear about fast (particularly developments in science/health), so hopefully that will make messages more accessible. I’ll let you know once I’ve sorted it.

Obviously I’d like to hear what you’d like to see. How would you like this blog to develop over the next year (or five!). Are there any particular things you’d like to see more/less of? Topics you want covered? People you’d like me to interview for the ‘quickies’ section of the blog? Campaigns you want covered? Let me know what your vision is for this blog.

So, happy fifth birthday blog. Big birthday kisses to those of you who’ve been with me from the beginning. For those of you who’ve only recently found this blog I hope you like it enough to stick around for the next half decade. I notice one of my favourite other blogs Mind Hacks has also celebrated it’s fifth birthday too, so congratulations to them.

Time to blow out the candles and make a wish. Of course, I can’t tell you what it is. You’ll have to come back in five years to find out if it’s come true.

We’re all familiar with the term ‘designer vagina’, but did you know there’s actually no clinical evidence to suggest non-essential female genital surgery is effective or safe? A systematic review of the literature on labial surgery for women (just out in the British Journal of Obstetrics and Gynaecology) has found “medically nonessential surgery to the labia minora is being promoted as an effective treatment for women’s complaints, but no data on clinical effectiveness exist”. The paper isn’t open access but is well worth a read if you can find it. It outlines the issues around genital surgery including why this trend is increasingly popular. Sadly women’s media is not massively critical on this topic, so here’s hoping this research might encourage a bit more critical reflection among editors (although I’m not holding my breath).

Predictably plastic surgeons haven’t responded massively well to this review – I wonder why? You might be shocked or amused to see one practitioner’s reaction courtesy of the BBC:
“Essentially this is just about removing a bit of loose flesh, leaving behind an elegant-looking labia with minimum scarring”.
As ever, The Daily Mash wade in with their satirical take on what makes a whole ‘perfect vagina’.

Are orgasms bad for your health? Well, yes, according to Marnia Robinson (lawyer turned sex expert) who suggests that orgasms ‘play havoc with your neurochemistry’ and recommends people should practice sexual intimacy without orgasm. This is an interesting theory, but it’s only a theory, and the data included in Robinson’s thesis seems to be selective rather than systematic. While Robinson rightly does talk about conventional messages about sex being around achievement and unrealistic goal setting, her message ultimately becomes less about personal choice and slips into the familiar rhetoric of their being a ‘right’ way to have sex. This story’s picked up on here.

Movie star Jane Fonda’s got the media in a fluster by announcing sex is still great aged 71. It’s led to the predictable discussions about whether it’s okay or not for seniors to be sexy – and a whole flurry of spin off features and radio programmes all arguing that older people ought to be getting it on, and are sexier than ever before. Which doesn’t quite fit the evidence. Some older people do report positive relationships and enjoying intimacy – although that may not necessarily involve lots of intercourse (or even any intercourse at all). Caution is required so we don’t reinforce the stereotype that anyone over 60 should be sexless, or pressurise older people to think sex is a mandatory activity and there’s something medically wrong if they’re not still doing it. [You might be interested in some blogs about senior sex I've written previously - all linked within this blog].

In anticipation of tomorrow’s Disability: sex, relationships and pleasure conference at the Royal Society of Medicine, The Times asks ‘Is sex for the disabled the last taboo?’. The piece covers some of the issues facing disabled people about relationships (it’s a bit limited by some inaccurate reporting in places – the comments after the piece I think are more interesting). I’ll be blogging a report on the conference early next week where I’ll be particularly focusing on some of the key questions of evidence based policy and practice relating to sex positive support for disabled people.

Want to know how to talk dirty? Here’s a quick guide I contributed to for Playboy about some common errors people make around naughty chat (over 18s only). [I was glad to see this feature didn't go down the usual uncritical approach to spicing up your sex life and encourages readers to reflect on why they want to talk dirty and ensure it's something their partner is equally interested in].

There are two key errors people make with sexy talk:
- The first is to assume their partner is fine with talking dirty without checking, and launching into some rude chat that embarrasses, upsets or unnerves them.
- The second is thinking talking dirty is something they ought to be doing, but not feeling sure what to say – or when to say it.

Talking dirty can be a real turn on, but isn’t everyone’s cup of tea. Saying something unexpectedly could really spice things up, but it also could be a disaster if you offend, upset or just make your partner fall about laughing. If you want to get better at communicating your desires I’d recommend Carol Queen’s Exhibitionism for the Shy.

Sex writer Brian Alexander contacted me recently with a problem he was answering from a reader of his Sexploration column. The woman in question had a partner who was getting off on her being sexually provocative with other men. It was hard to tell if this was a case of a couple with communication problems, or a guy being controlling and forgetting the key rules of acting out sexual fantasies – that it must always be safe, sane and consensual. You can read the problem and answer here.

Finally, the fantastic international sex education campaign 15 and counting have launched a competition where rappers, singers and musicians have been composing songs relating to the campaign. All the entries can be found here. With some of the most popular here. My favourite is Hemanifezt – Be a Protector for Yourself.

So if you’re a musician, song writer or performer why not contribute your song to the competition? Educators working within schools or healthcare may want to encourage young people to get involved in the competition. And feel free to share this information – both about 15 and counting and this music comp.

And if you want a bit of inspiration, let’s go back to the 90s with a groundbreaking safer sex song that still sounds great today.

Let’s talk about sex!

A couple of weekends ago the New View Campaign (who work to challenge the medicalisation of sex) hosted an event called Vulvagraphics.

The aim of the event was to celebrate genital diversity. The site above contains links to the various exhibitions that featured in the event. All of which represent a diversity of vulvas depicted in art, film, drama, literature and craft.

In an era where we’re used to seeing surgically enhanced or airbrushed images of vulvas, and at a time when we tend to focus on vulvas in negative ways (as dirty, hairy or smelly), Vulvagraphics invited women and men to rethink how they view the vulva.

Photos of the event (including a variety of vulvas) can be seen here. Viva la Vulva posters and ‘love your vulva’ badges are available here.

This might be an event you respond to by wondering what those kooky feminists are up to now? However, it does have an important message about body awareness and confidence. It is worth reading about the event and seeing how you might apply the messages from it. That might be individually in terms of your own body confidence, or as a means of celebrating your vulva with a partner. Or if you’re a parent it might enable you to think how you can encourage your children to feel proud and positive about their genitals. Teachers, sex educators and healthcare staff could also reflect on how they currently deliver messages about genitals – and whether those could be improved and made sex positive.

So go ahead. Love your vulva. Or if you don’t happen to have one, love someone else’s